Fill out the following form to request your appointment with the Center for Intimate Health and Wellness.

Please allow 24 hours for a phone call from our staff after submitting your request.

This form is for new Center for Intimate Health patients only. If you are already a patient, please use PatientSite to request your appointment.

Appointment requests are for non-urgent concerns. If you have an urgent medical concern, call 911.

This form is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.